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Multifactorial causes of irritating bladder symptoms in patients with sjögren's syndrome
Author(s) -
Lee KuangLun,
Dong Chung Shiu,
Chen MaoYuan,
Ho ChenHsun,
Tai HuaiChing,
Hung ShunFa,
Yu HongJeng
Publication year - 2011
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.20887
Subject(s) - medicine , nocturia , lower urinary tract symptoms , overactive bladder , interstitial cystitis , etiology , urology , urination , urinary system , polyuria , prostate , pathology , endocrinology , alternative medicine , cancer , diabetes mellitus
Aims Patients with Sjögren's syndrome (SS) are reported to have an increased severity of irritating bladder symptoms, including urinary frequency and urgency. The mechanism remains unclear. The aim of this study is to elucidate the possible etiologies underlying this problem. Methods Data from 23 female patients with SS (15 primary and 8 secondary) who were treated in the urology clinic for chronic, irritating bladder symptoms were studied. Evaluation of each subject is composed of lower urinary tract symptoms (LUTS), bladder diary entries, and urodynamic studies, which also included an ice water test (IWT) to detect the presence of a C‐fiber mediated micturition pathway. Interstitial cystitis (IC) was diagnosed with post‐hydrodilatation cystoscopic findings of glomerulations and a KCl test. Results These patients complained predominantly of overactive bladder symptoms (OAB), including frequency (n = 20, 87%), nocturia (n = 16, 66%), and urgency (n = 12, 52%). Based on the aforementioned evaluations, four patients (17%) had polyuria with normal bladder function, nine patients (39%) had detrusor overactivity (DO), seven patients (32%) had bladder hypersensitivity (including two patients (9%) diagnosed with IC), and three patients (13%) had negative findings. Ice water instillation neither elicited novel involuntary contractions, both in those with or without DO. Five of the six patients (83%) with DO versus one of the four patients (25%) without DO responded to antimuscarinic therapy. Conclusions Various factors contribute to the irritating bladder symptoms in patients with SS, with DO being predominant. The LUTS developed in patients with SS are not due to any specific single etiology and that each patient must be individually carefully evaluated. Neurourol. Urodynam. 30:97–101, 2011. © 2010 Wiley‐Liss, Inc.